| Reimbursement and value-based pricing: stratified cost-effectiveness analysis may not be the last word. | |
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MedLine Citation:
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PMID: 20568075 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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During recent discussions, it has been argued that stratified cost-effectiveness analysis has a key role in reimbursement decision-making and value-based pricing (VBP). It has previously been shown that when manufacturers are price-takers, reimbursement decisions made in reference to stratified cost-effectiveness analysis lead to a more efficient allocation of resources than decisions based on whole-population cost-effectiveness analysis. However, we demonstrate that when manufacturers are price setters, reimbursement or VBP based on stratified cost-effectiveness analysis may not be optimal. Using two examples - one considering the choice of thrombolytic treatment for specific patient subgroups and the other considering the extension of coverage for a cancer treatment to include an additional indication - we show that combinations of extended coverage and reduced price can be identified that are advantageous to both payers and manufacturers. The benefits of a given extension in coverage and reduction in price depend both upon the average treatment benefit in the additional population and its size relative to the original population. Negotiation regarding trade-offs between price and coverage may lead to improved outcomes both for health-care systems and manufacturers compared with processes where coverage is determined conditional simply on stratified cost-effectiveness at a given price. Copyright © 2010 John Wiley & Sons, Ltd. |
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Authors:
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Neil Hawkins; David A Scott |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Health economics Volume: 20 ISSN: 1099-1050 ISO Abbreviation: Health Econ Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-04-01 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9306780 Medline TA: Health Econ Country: England |
Other Details:
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Languages: eng Pagination: 688-98 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 John Wiley & Sons, Ltd. |
Affiliation:
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Oxford Outcomes, Oxford, UK. neil.hawkins@oxfordoutcomes.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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